Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $305.10 / $305.10 / $786.25	Facility		$305.10	$305.10	$786.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $99.56 / $173.18	Professional		$81.59	$99.56	$173.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $15.03 / $53.63	Professional	26	$14.19	$15.03	$53.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $76.68 / $149.21	Professional	TC	$67.40	$76.68	$149.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $621.47 / $77,999.99 / $94,999.99	Facility		$621.47	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.19 / $24.19 / $164.05	Professional		$24.19	$24.19	$164.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.06 / $168.90 / $243.46	Facility		$140.06	$168.90	$243.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.19 / $24.19 / $29.90	Facility	26	$24.19	$24.19	$29.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.13 / $132.69 / $208.87	Professional		$82.13	$132.69	$208.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $24.19 / $37.81	Professional	26	$16.39	$24.19	$37.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.14 / $105.92 / $169.43	Professional	TC	$64.14	$105.92	$169.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $154.05 / $243.46	Facility		$104.71	$154.05	$243.46
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $24.19 / $24.19 / $29.90	Facility	26	$24.19	$24.19	$29.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.87 / $164.05 / $263.97	Professional		$102.87	$164.05	$263.97
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $24.19 / $31.59	Professional	26	$16.26	$24.19	$31.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $64.14 / $109.03 / $153.47	Professional	TC	$64.14	$109.03	$153.47
United Facility/Professional Facility Modifier Low / Median / High Price $132.53 / $132.53 / $132.53	Facility		$132.53	$132.53	$132.53
United Facility/Professional Professional Modifier Low / Median / High Price $85.95 / $98.89 / $291.36	Professional		$85.95	$98.89	$291.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $17.32 / $29.15	Professional	26	$16.60	$17.32	$29.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.06 / $82.29 / $144.52	Professional	TC	$70.06	$82.29	$144.52